IMPACT ON THE QUALITY OF LIFE OF PATIENTS RECEIVING CHEMOTHERAPY FOR METASTATIC COLORECTAL CANCER: A SYSTEMATIC REVIEW

Abstract

Background Despite chemotherapy being widely used as treatment option for metastatic colorectal cancer to prolong life, side effects of chemotherapy can potentially affect the Quality of Life (QoL) in patients. Measurement of QoL is becoming an important component of treatment outcome and clinical decision making. Objectives To assess and summarise available evidence that explores the impact of chemotherapy on the QoL of patients with metastatic colorectal cancer using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Search Methods Systematic search was conducted using PubMED, Scopus, ProQuest Dissertations & Theses, CINAHL, PsycINFO, EMBASE, CENTRAL and Web of Science from inception to January 2021. Selection Criteria Eligible studies included RCTs and non-RCTs in which QoL was measured using the EORTC QLQ-C30 questionnaire in adult patients with metastatic colorectal cancer who were undergoing chemotherapy. Data collection and analysis Using a standardized data form, data was extracted based on participants, interventions, and outcome of interest. Due to data insufficiency and heterogeneity of studies, the results were synthesized narratively. Results We included 14 RCTs and 5 non-RCTs (3 prospective longitudinal studies, 1 observational cohort studies and 1 phase I clinical trial) on 6014 participants. In the 5 non-RCTs, the risk of bias was judged to have mostly moderate risk of bias across all domains with 1 study having a ‘serious’ rating in the risk of confounding. The remaining 14 RCTs were judged to have low or unclear risk of bias with high risk of detection bias. This review shows that global QoL remained stable with detrimental effects on the symptoms of diarrhea, nausea and vomiting. Conclusion This review suggests QoL remained stable in patients suffering from metastatic colorectal cancer with side effects after chemotherapeutic treatment. Strengths and limitations of study - A comprehensive search of the published literature was being conducted in major databases from inception to January 2021 - The search of ongoing clinical trials, and theses and dissertations were being conducted - No meta-analysis was conducted to pool data together and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was not utilised to assess the quality of evidence.